To enable tissue function-based tumor diagnosis over the large number of existing digital mammography systems worldwide, we propose a cost-effective and robust approach to incorporate tomographic optical tissue characterization with separately acquired digital mammograms. Using a flexible contour-based registration algorithm, we were able to incorporate an independently measured two-dimensional x-ray mammogram as structural priors in a joint optical/x-ray image reconstruction, resulting in improved spatial details in the optical images and robust optical property estimation. We validated this approach with a retrospective clinical study of 67 patients, including 30 malignant and 37 benign cases, and demonstrated that the proposed approach can help to distinguish malignant from solid benign lesions and fibroglandular tissues, with a performance comparable to the approach using spatially coregistered optical/x-ray measurements.
We have previously demonstrated the utilization of spatially co-registered diffuse optical tomography (DOT) and digital breast tomosynthesis (DBT) for joint breast cancer diagnosis. However, clinical implementation of such a multi-modality approach may require development of integrated DOT/DBT imaging scanners, which can be costly and time-consuming. Exploring effective image registration methods that combine the diagnostic information from a standalone DOT measurement and a separate mammogram can be a cost-effective solution, which may eventually enable adding functional optical assessment to all previously installed digital mammography systems. In this study, we investigate a contour-based image registration method to convert independent optical and x-ray scans into co-registered datasets that can benefit from a joint image analysis. The breast surface used in 3D optical DOT reconstruction is registered with the breast contour line extracted from an x-ray mammogram acquired separately. This allows us to map the 2D mammogram to the optical measurement space and build structural constraints for optical image reconstruction. A non-linear reconstruction utilizing structure-priors is then performed to produce hemoglobin maps with improved resolution. To validate this approach, we used a set of tumor patient measurements with simultaneous DOT/DBT and separate 2D mammographic scans. The images recovered from the registration procedure derived from DOT and 2D mammogram present similar image quality compared to those recovered from co-registered DOT/DBT measurements.